A Review of State Emergency Prescription Refill Protocols

by Jane Kim

The recent Ebola outbreak in West Africa and its spread to other countries serve as an urgent warning for U.S. health care systems to be adequately prepared for any emergency. Community pharmacies and pharmacists play a distinct role in our health care system with established relationships with patients and local, state, and federal departments of health as well as accessible distribution networks that remain critical during a PHE1. Success in the disaster response after Hurricane Katrina was partly attributed to pharmacy continuity services – allowing patients to receive prescriptions from their community pharmacist who ensured safety and accuracy while avoiding crowding of emergency departments. 

For pharmacists to adequately prepare for potential disasters, it is imperative for all states (and the District of Columbia) to clearly define emergency prescription refill protocols and allow pharmacists to dispense an emergency 30-day supply of medications, specifically during times of a public health emergency, and to make this information readily available and accessible to pharmacists and the public.

More than half the states only allow for a 72-hour emergency supply or no emergency supply at all. A 72-hour emergency supply may not be adequate for certain public health emergencies. During Katrina, one health care team discovered that dispensing 14-day supplies of medications was not enough to provide continuity of care and 30-day supplies to displaced disaster victims was preferred3. Moreover, pharmacists may be hesitant to dispense only a 72-hour supply due to medication-packing limitations and inventory control4.            

As changing or adding state laws may be a cumbersome and arduous process, all state board of pharmacies without current laws regarding emergency prescription refills by pharmacists during a public health emergency are highly encouraged to initiate the process in order to be properly prepared for disasters in the future. In the meanwhile, it may be easier to leverage state boards of pharmacy to add umbrella rules as the boards have the power to regulate pharmacy practice under current legislation.

ngd-Michigan does not have emergency refill laws and does not have any standard for a reasonable emergency prescription amount.

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